What makes the Harrisburg Patriot News article noteworthy is that these tales aren’t being whispered in my conference room by nurses who are too afraid to speak openly or by patients who must pit their credibility against a denial by the physician and the O.R. staff. Instead, the Harrisburg Patriot News is reporting in public the official findings of a state agency (the Pennsylvania Patient Safety Authority) and this authority gets its information from the self-reports of hospitals.
The article reports that during a 31 month period that ended last October, Pennsylvania hospitals self-reported 177 incidents of “disruptive behavior” that put patients at risk. Reported examples of “disruptive behavior” included:
* a surgeon storming out of the operating room, leaving others to finish the job.
* a doctor refusing to wait for an anesthetic to be applied to a baby, and performing a circumcision that left the baby in terrible pain.
* a doctor dropping instruments on the floor, ignoring an offer of replacements, and using the contaminated items on a patient.
Now, my brother and sister are surgeons. I know many other doctors. I am firmly convinced that the vast majority of doctors and nurses are highly skilled, responsible and caring people. But some are not. And in my experience, physicians are simply unwilling to take action to police one of their own even when that one is plainly out of control and harming patients.
I could tell you horror stories of cases that were confidentially resolved for huge amounts. For example, there was the case of a heart surgeon who let a patient with a dissecting aorta and who needed emergency surgery lie in an Erie hospital, turning blue, asking why she wasn’t getting the emergency surgery she’d been told she needed. The patient lay there for hours while nurses held her hand and tried to comfort her. All the while the nursing staff was inwardly fuming at the inaction and inattention of the surgeon. And that’s not even the most offensive aspect of the story, to me. What’s most offensive is that there were doctors there who did not forcefully intervene and shame the surgeon into action. The patient died. She died in fear. She died for lack of surgical care in the middle of a cardiac surgery unit.
The article is more even handed than I am about these things. It’s easier to be even handed when your source material is a state agency report. When your information comes from family members and victims who tell you these stories through tears it’s more difficult to be even handed about it, admittedly.
If you’re interested in systemic problems in health care, the article is worth a read. It goes beyond the problems of disruptive behavior and touches on other systemic problems such as the absence of effective communications between the physicians and nursing staff in most hospitals.